Under-treatment of Pain

Marijuana policy initiatives are on the ballot in four states today, so is sentencing reform in Ohio, the FDA approves a powerful new opioid, El Chapo goes on trial in New York, and more.

Do your civic duty today. (Creative Commons)

Marijuana Policy

Marijuana Legalization, Medical Marijuana on the Midterm Ballot Today. It's not just about control of the Congress. Four states are seeing statewide marijuana policy initiatives: In Michigan and North Dakota, legalization is on the ballot; in Missouri and Utah, medical marijuana in on the ballot. Also, a number of Ohio localities are voting on decriminalization, and in Wisconsin, a number of localities will be voting on non-binding referenda on whether to legalize marijuana. Come back tomorrow for results.

Heroin and Prescription Opioids

FDA Approves Opioid Pain Reliever 1,000 Times Stronger Than Morphine. The Food & Drug Administration has approved a new opioid pain reliever that is a thousand times stronger than morphine and ten times stronger than fentanyl. The new drug, Dsuvia, will be used as a fast-acting alternative to intravenously administered opioids in hospitals. Critics warned that the new drug could be abused, but FDA Commissioner Scott Gottlieb said in a statement that it will only be used with "very tight restrictions."

Law Enforcement

El Chapo Goes on Trial in New York City. Longtime Sinaloa Cartel leader Joaquin "El Chapo" Guzman has gone on trial in New York City this week. El Chapo was extradited to the US in 2017 after escaping from a Mexican prison and being recaptured months later, and now faces a 17-count federal indictment for his role heading the cartel, including money laundering, firearms, and multiple murder charges. Although El Chapo has been out of circulation for more than a year, the Sinaloa Cartel remains arguably the most powerful of Mexican drug trafficking organizations.

Sentencing

Ohio Votes on Whether to Defelonize Drug Possession Today. Voters in the Buckeye State will have a chance to approve the Issue 1 sentencing reform initiative. The initiative would move most drug possession charges from felonies to misdemeanors. It would also allow some nonviolent offenders to receive 25% sentence reductions and would also prohibit jail time as a sentence for using or possessing drugs until the third offense within 24 months. Come back tomorrow for results.

International

Israeli Finance Minister Criticizes Delay in Approving Medical Marijuana Exports. Finance Minister Moshe Kahlon blamed the Public Security Ministry for foot-dragging on allowing exports of the herb, thus "harming Israel's economy, farmers and local industry," and called for the cabinet to act to approve exports and advance legislation. "For more than six months, the Public Security Ministry has been preventing the plan from being put on the cabinet's agenda, thereby harming Israel's economy, farmers and local industry," Kahlon wrote in a memo Monday to the cabinet secretary. "During these months a number of countries around the world, including Australia and Canada, began to export medical cannabis."

The Justice Department creates a new anti-cartel task force, a California summit will address issues around chronic pain and the war on drugs, the New York Assembly holds a hearing on marijuana legalization, and more.

New York State Assembly Holds Hearing on Marijuana Legalization. Four legislative committees held a joint hearing on marijuana legalization in Albany Tuesday. The hearing covered how marijuana should be legalized, taxed, and regulated. The hearing comes ahead of next year's legislative session when lawmakers are expected to take up proposals to legalize the herb.

Medical Marijuana

New Jersey Will Let Dispensaries Post Price Information. State officials announced late last week that medical marijuana dispensaries can post their product prices online, so now patients can shop around and be better-informed consumers. "Medical marijuana patients should benefit from online price information just as shoppers do when they buy a car, a plane ticket or any other consumer goods," Department of Health Commissioner Shereef Elnahal said in a statement. Listing prices is not mandatory, however.

Heroin and Prescription Opioids

California Pain Summit Set for Next Month. Over a hundred California physicians, administrators, policymakers, and advocates will be meeting at the For Grace's Change Agent Pain Summit in Los Angeles on November 2. For Grace is a group devoted to dealing with women's issues around pain. The aim of the summit is to create a patient-centered state-level pain policy is to localize key recommendations from the National Institutes of Health's National Pain Strategy in the Golden State. Among those attending will be Diane Hoffman, director of the Law and Health Care Program and Jacob A. France Professor of Health Care Law at the University of Maryland. "There's an imbalance in our drug control laws and policies between treating pain and reducing drug diversion and addiction. And it's hurting pain patients," said Hoffman. "The efforts to restrict prescribing and eliminate Medicaid coverage of opioids, like what has been proposed in Oregon and the outright abandonment of patients is outrageous. We need more leadership from the medical community," she added.

Law Enforcement

Justice Department Creates New Task Force Targeting Cartels, MS-13. Attorney General Jeff Sessions announced at a Washington conference Monday that the Justice Department has created a new task for aimed at breaking three Mexican drug cartels and the MS-13 street gang. Sessions described the groups, along with Hezbollah, as top transnational organized crime threats and said DOJ would "develop a plan to take each of these groups off the streets for good." The three cartels named are the Sinaloa Cartel, the New Generation Jalisco Cartel, and the Gulf Clan. All of this because the last half-century of drug prohibition has worked so well.

New Jersey Legislative Committee Advances Parole System Reform. The Assembly Law and Public Safety Committee voted 4-3 Monday to advance a bill, Assembly Bill 1986, which rewards good behavior and encourages rehabilitation by allowing for the release of low-risk individuals from prison after they have served their basic sentence, provided they commit no serious disciplinary infractions while incarcerated and participate in rehabilitation programs.

By the end of 2013, the country's quiet opioid addiction crisis was no longer so quiet. Opioid overdose deaths that year topped 16,000, more than four times the same statistic for 1999. That prompted a number of measures at the state and federal level to rein in opioid prescriptions, including a move by the DEA in October 2014 to tighten its policies around some of the most commonly prescribed opioids.

The new DEA policy -- aimed at popular opioids such as Vicodin and Lortab -- imposed restrictions on doctors' prescribing and made it more difficult for patients to get refills. In one sense, the policy was a success: Prescriptions for those drugs decreased almost immediately. But new research adds to an increasing body of evidence that restricting opioid prescribing has not solved the opioid crisis but instead worsened it.

Since the DEA policy shift, opioid overdose deaths continued to grow with more than 40,000 fatal opioid overdoses in 2016. And while prescription opioid overdose deaths have slightly decreased -- there were about 14,000 that year -- overdose deaths from heroin and non-prescription synthetic opioids such as fentanyl went through the roof. Heroin and illicit synthetics accounted for nearly two-thirds of all opioid overdose deaths in 2016.

In the new study, published this week in the British Medical Journal, researchers examining the impact of the DEA policy shift found evidence that while the change indeed lowered prescribing rates for the opioids in question, it was also linked to an increase in illicit online sales of those drugs in Dark Web drug markets.

The researchers used software called DATACRYPTO to crawl encrypted Dark Web marketplaces where people can anonymously buy damned near anything, from drugs to guns to credit card numbers. DATACRYPTO harvested data on which drugs were for sale, their country of origin, and the number of customer comments on each seller's comments page. Researchers used that last figure as a proxy for how much of a drug that seller sold. They examined sales of prescription opioids, sedatives, stimulants, and steroids, as well as heroin. It was only with prescription opioids that they found a significant Dark Web sales bump.

Here's what they found: "The sale of prescription opioids through US cryptomarkets increased after the schedule change, with no statistically significant changes in sales of prescription sedatives, prescription steroids, prescription stimulants, or illicit opioids."

According to their data, prescription opioids doubled their market share of U.S. Dark Web drug sales thanks to the DEA policy change. By July 2016, opioids represented 13.7% of all drug sales in U.S. cryptomarkets, compared with a modeled estimate of 6.7% of all sales.

While the researchers were careful to not make claims of causation -- only correlation -- their conclusion speaks for itself: "The scheduling change in hydrocodone combination products coincided with a statistically significant, sustained increase in illicit trading of opioids through online US cryptomarkets. These changes were not observed for other drug groups or in other countries. A subsequent move was observed towards the purchase of more potent forms of prescription opioids, particularly oxycodone and fentanyl."

Not only is the DEA policy change linked to increased Dark Web opioid sales, it is also linked to a move toward more powerful, and thus more dangerous, opioids. The researchers noted that while fentanyl was the least purchased Dark Web opioid in the summer of 2014, it was the second most frequently purchased by the summer of 2016. Fentanyl killed as many people as prescription opioids that year.

This study -- one of the few that examines supply reduction (as opposed to demand reduction) as a means reducing drug use -- strongly suggests that supply-side interventions carry unintended consequences, especially the resort to more dangerous and more powerful substitutes. The study's authors refer to this effect as "the iron law of prohibition, whereby interventions to reduce supply, such as increased enforcement and changes to drug scheduling, lead to illicit markets dominated by higher potency products."

Perhaps better than restricting opioid prescriptions, which has deleterious impacts on the tens of millions of Americans suffering chronic pain, or other supply-side interventions, would be increased access to addiction treatment, as well as greatly expanded harm reduction measures to try to get people off opioids and keep them alive in the meantime.

The Justice Department wants to crack down on pail pill production. And Congress is eyeing action, too. (Wikimedia)

Marijuana Policy

Maine Legislature Passes Legal Marijuana Implementation Bill, Governor Vows Veto. The state Senate on Tuesday approved the bill that would finally allow retail marijuana sales. The bill passed the House earlier and now goes to the desk of Gov. Paul LePage, who has threatened to veto it because it doesn't combine the state's adult use marijuana and medical marijuana regimes. LePage vetoed a similar bill last year. But this time around, the bill passed with enough support to overcome a veto. LePage has 10 days to sign, veto, or let the bill become law without his signature.

Medical Marijuana

Bipartisan Bill to Let VA Study Medical Marijuana Filed. A group of House Democrats and Republicans have filed HR 5520, the VA Medicinal Cannabis Research Act. The bill would clarify that the Veterans Administration has the authority to study medical marijuana and encourages the agency to do so. The bill would require the VA to report regularly to Congress about its progress on medical marijuana research. The bill is being championed by leaders in the House Veterans Affairs Committee and has 34 cosponsors.

Massachusetts High Court Urges Lawmakers to Clarify Law on Home Cultivation. In an opinion in a case of a medical marijuana patient arrested for growing 22 pot plants, the state's Supreme Judicial Court has urged lawmakers to revisit the law around home grows by patients. The law allows patients to grow enough marijuana to create a 60-day supply, defined in the state as 10 ounces. But the justices found the current law problematic and suggested a plant-based limit would be clearer. "Statutory and regulatory clarification would be most beneficial," wrote Justice Scott Kafker in the opinion in the case, Commonwealth vs. Richardson.

Justice Department Proposes New Regulations to Limit Prescription Opioid Production. Attorney General Jeff Sessions on Tuesday proposed new regulations for how the DEA sets opioid production quotas that could severely limit the amount of pain pills produced. "Under this proposed new rule, if DEA believes that a company's opioids are being diverted for misuse, then they will reduce the amount of opioids that company can make," Sessions said in prepared remarks. The proposed change must still go through the federal rule-making process before going into effect. It will be published in the Federal Register and opened to public comment in coming days.

Bernie Sanders Files Bill to Rein in Big Pharma on Opioids. Sen. Bernie Sanders (I-VT) on Tuesday filed Senate Bill 2961, which would ban drug companies from marketing opioids as non-addictive and fines them 25% of their profits if they violate the rule. The bill also seeks to stop pharmaceutical companies from distributing amounts of opioids "not medically reasonable," in a bid to stop distributors from flooding small towns with pills. "We know that pharmaceutical companies lied about the addictive impacts of opioids they manufactured," Sanders said in a statement. "They knew how dangerous these products were but refused to tell doctors and patients," he said. "Yet, while some of these companies have made billions each year in profits, not one of them has been held fully accountable for its role in an epidemic that is killing tens of thousands of Americans every year."

The Bangladeshi Department of Narcotics Control has proposed new drug legislation for the country which includes the use of the death penalty for people caught selling more than 200 grams of methamphetamine. Under current law, the maximum punishment is 15 years in prison. Bangladeshi law already allows the death penalty for some other drug offenses, including heroin trafficking, but its use is actually very rare in the country. The last execution for a drug offense was in 2009.

Chronic pain patients will be rallying at state capitals Saturday to demand they not be sacrificed on the altar of the war on opioids, Massachusetts throws out 11,000 drug cases linked to a disgraced state lab chemist, and more.

For the second time, a disgraced state drug lab chemist has cost Massachusetts thousands of drug convictions. (af.mil.gov)

Marijuana Policy

New Jersey Group Pushes for More Minorities in Marijuana Business. The New Jersey Minority Alliance has been in talks with Sen. Nicholas Scutari (D), the lead sponsor of the marijuana legalization bill, Senate Bill 30, about revising it to expand minority inclusion. The group has a Social Equity Program under which communities adversely affected by the drug war would be given special consideration to establish marijuana operations. The plan would also remove barriers to entry related to prior drug arrests. Scutari says he finds the plan "interesting."

Heroin and Prescription Opioids

Chronic Pain Patients to Rally on Saturday. Concerned that the crackdown on prescription opioids in the midst of the country's opioid problem is leaving them without sufficient access to pain medications, chronic pain patients will be rallying in 45 state capitals on Saturday. The Don't Punish Pain Rally aims to fight the stigma against people with chronic or intractable pain and bring awareness to the many suffering under new prescription guidelines. "Our government really doesn't belong intruding into the physician-patient relationship and that's what's happening, said Deborah Toucheshawks, one of the senior rally organizers. "When I get a message [that] my family member has end-stage cancer and they won't give him anything for pain and now he wants to kill himself, that's a problem."

Criminal Justice

Massachusetts Court Throws Out 11,000 Drug Convictions Tainted By State Chemist. The state's highest court on Thursday threw out more than 11,000 drug convictions where evidence was tainted by being analyzed by disgraced state chemist Sonja Farak. Farak had worked as a chemist at the state's Amherst drug lab from 2004 until 2013, when she was arrested for stealing cocaine from the facility. She later admitted that during that entire period, she treated the drug lab's evidence supply as her own personal stash and tested seized drugs while under the influence of meth, cocaine, ketamine, ecstasy on a daily basis. Farak isn't the first state lab chemist to flame out and cost the state thousands of convictions. Last year, more than 21,000 convictions were thrown out in cases linked to Annie Dookhan, who admitted doctored the results of about one is six drug cases tried in the state between 2003 and 2012.

The White House could announce a national opioid emergency on Thursday, the DEA releases its annual drug threat assessment, the Maine legislature approves a marijuana regulation bill, and more.

The opioid epidemic is front and center in the drug policy debate, and in the eyes of the DEA. (wikimedia.org)

Marijuana Policy

Maine Legislature Passes Marijuana Regulation Bill, Governor May Veto. The legislature approved a bill to regulate the state's impending legal marijuana market Monday, but not by big enough a margin to withstand an expected veto by Gov. Paul LePage (R). The bill would set up a licensing system and set a 10% sales tax and a weight-based excise tax for transactions between growers and retailers. If LePage vetoes the bill, the result could be "chaos" that would throw "oxygen onto the fire of the black market," said Sen. Roger Katz (R-Augusta) in remarks reported by the Bangor Daily News. LePage has said he wants to postpones retail sales until next year.

Heroin and Prescription Opioids

White House to Host Opioid Event on Thursday. The White House Office of National Drug Control Policy has announced that it will host an event Thursday on "the nationwide opioid crisis." The announcement did not make clear what the event will be, but could be the declaration of a national emergency around the opioid crisis. President Trump surprised his advisors last week by saying he would make such an announcement this week.

Trump Opioid Commission Member Not Optimistic. In an interview Monday, Trump opioid commission member former Rep. Patrick Kennedy (D-RI) said he was not optimistic that any recommendations from the commission will lead to any effective action to ameliorate the opioid crisis. Kennedy told the Washington Post "the worry is that" the commission's final recommendations, set for release next week, "won't be adopted."

Drug Store Group Offers Recommendations to Ease Opioid Crisis. The National Association of Chain Drug Stores, which has been criticized on some fronts for contributing to the crisis, has suggested four public policy initiatives that could help rein it in. Among the policy prescriptions are a seven-day limit for initial opioid prescriptions, nationwide electronic prescription monitoring, the use of manufacturer-funded envelopes to return unused opioids, and regulation of synthetic opioids. The association did not address the impact such policy prescriptions could have on chronic pain patients.

Law Enforcement

DEA Releases 2017 National Drug Threat Assessment. The agency released its annual report Monday, and it concentrates on the opioid crisis. The report notes the high number of prescription opioid overdose deaths, warns that heroin is a "serious public health and safety threat," notes the rise of fentanyl, says "the methamphetamine threat remains prevalent," "the cocaine threat continues to rebound," and that the emergence of new psychoactive substances remains "a challenge," among other findings. It qualifies Mexican drug trafficking organizations as "the greatest criminal drug threat in the United States."

The attorney general makes clear yet again that he doesn't like legal weed, a Kentucky court throws out a medical marijuana lawsuit, one of the nation's largest pharmacy chains is moving to tighten up on opioid prescriptions, Rodrigo Duterte is ready to kill his own kid for the sake of the drug war, and more.

Attorney General Sessions reprises a favorite theme even as his underlings ponder what to do about legal cannabis. (senate.gov)

Marijuana Policy

Sessions Attacks Marijuana Legalization Again. "I've never felt that we should legalize marijuana," Sessions said Wednesday in San Diego in remarks reported by Reuters. "It doesn't strike me that the country would be better if it's being sold at every street corner," he added, noting that it remains prohibited under federal law. But despite the attorney general's repeated anti-legalization comments, the Justice Department has yet to move seriously against states where it is legal. Last week, Deputy Attorney General Rod Rosenstein said the Cole memo, which set the Obama administration's largely laissez-faire policy toward legal pot states, is now under review.

Maine Legislators Propose Online and Drive-Through Pot Sales. Proposed regulations from the legislature's marijuana committee would let adults buy pot over the Internet and at drive-through windows at licensed pot shops. The rules are not yet set, however, and opponents are seeking to tighten access. Stay tuned.

Las Vegas Gets First 24-Hour Pot Shop. The city council voted unanimously Wednesday to allow a pot shop, Oasis Cannabis, to stay open 24 hours a day. It will be the first 24/7 pot shop to be located near the Strip, but other pot shops in nearby North Las Vegas are already open around the clock. In approving the move, the council overrode its own city code, which requires pot businesses to shut down between 3:00am and 6:00am.

Medical Marijuana

Kentucky Court Dismisses Lawsuit Aimed at Governor, Attorney General. A lawsuit filed against Gov. Matt Bevin (R) and Attorney General Andy Beshear (D) seeking to force them to legalize medical marijuana in the state was thrown out Wednesday. A Franklin circuit court judge ruled that legal precedent makes it clear that only the legislature can regulate the use of marijuana in the state -- not the executive branch and not the courts.

Heroin and Prescription Opioids

CVS to Limit Opioid Prescriptions in Bid to Address Crisis. The national drug store chain announced Thursday it will take steps to limit initial prescriptions to seven-day supplies for new patients facing acute pain. It will instruct pharmacists to contact prescribing doctors if they see prescriptions with what they believe are more opioids than necessary. The chain will also cap daily dosages and require new patients to get medications that offer short-period pain relief instead of longer duration ones. CVS did not address how the moves would impact patients suffering from chronic pain.

Nevada Governor Sets Opioid Task Force Meeting. Gov. Brian Sandoval (R) has announced that the state's task force on opioid abuse is set to meet Monday. He said the task force will hear updates from state and federal agencies on their progress in fighting opioid abuse. The task force has already made the overdose reversal drug naloxone available to first responders, Sandoval noted.

Asset Forfeiture

lIllinois Governor Signs Civil Asset Forfeiture Reform Bill. Gov. Bruce Rauner (R) signed House Bill 303 into law on Tuesday. The new law does not end civil asset forfeiture, but raises the bar for seizures, mandates the collection and reporting of seizure data, and imposes new sanctions for abuse or violations of asset forfeiture rules. Under the new law, the government's burden of proof standard rises from probable cause to a preponderance of the evidence. The law also provides that possession of small amounts of drugs will no longer be a legal basis for forfeiture.

International

Duterte Tells Cops to Kill His Own Son if Drug Smuggling Rumors Are True. In a not very reassuring effort to demonstrate that his own family is not above the law, Philippines President Rodrigo Duterte said in a speech Wednesday that police could kill his children if they prove to be involved in drugs. The remarks came amid reports that his 42-year-old son Paolo was involved in drug smuggling. According to the Sydney Morning Herald, Duterte said he warned his son: "My orders are to kill you if you are caught, and I will protect the police who kill you." That way, people wouldn't think the first family was getting special treatment. "That's better ... so I can say to the people: "There, you keep talking. That's my son's corpse,' he said.

The California safe injection bill comes up two votes short of passing this year, Toronto authorities ignore the pleas of pot lounge operators for a place under legalization, Virginia's Democratic attorney general comes out with a plan to fight opioid overdoses, and more.

No safe injection sites for California this year. Maybe next year. (vch.ca)

Marijuana Policy

New Mexico Democratic Gubernatorial Candidates Want to Legalize It, Republicans Not So Much. Three leading Democratic contenders for the party's gubernatorial nomination support legalization, while the sole Republican in the race does not. Democrat Peter DeBenedittis released a statement Monday calling for legalization, prompting Democrats Jeff Apodaca and US Rep. Michelle Lujan Grisham to come out for it as well. The sole Republican, US Rep Steve Pearce opposes legalization, as does one Democrat, state Rep. Joseph Cervantes. But Cervantes noted that he has sponsored legislation reducing penalties for possession.

Virginia Attorney General Releases Plan to Fight Opioid Epidemic. State Attorney General Mark Herring (D) on Monday released a plan to address the growing number of deaths caused by the use of heroin, fentanyl, and prescription opioids. Among the proposals: harsher laws for people dealing in fentanyl, enhanced electronic prescription monitoring, requiring health insurers to cover alternative treatments for pain, teaching schoolchildren about opioids beginning in middle school, and an investigation into price gouging by companies selling naloxone. News accounts don't indicate any discussion in Herring's plan of the need to ensure the availability of opioid pain relievers to those patients who do need them, nor any critical examination of his proposal for increased sentences.

Toronto Just Says No to Marijuana Lounges. Despite the pleas of pot consumption lounge owners, some of whom have been open for years, the city's municipal standards and licensing committee voted 4-1 to limit marijuana businesses to government-run stores. The committee also voted to increase penalties for businesses that allow on-site consumption. The city is staying within the parameters set by the Ontario provincial government, which recently announced plans for a government monopoly on pot sales.

Peru Medical Marijuana Bill Advances. Spurred by a recent raid on a makeshift medical marijuana facility that mothers were using to soothe their sick children, the Peruvian congress is advancing a medical marijuana bill. The bill has now passed the congressional Committee on National Defense and heads to the full Congress for debate and a final vote. President Pablo Kucyzinski has supported the legislation.

Amnesty International Criticizes Indonesia's Turn to Harsh Drug War. The government's tough stance against drug dealers is leading to an increasing death toll, the human rights group said. Amnesty's Indonesian affiliate said some 80 people had been killed by police in the drug war so far this year, more than four times as many as last year.

(This article was prepared by StoptheDrugWar.org"s lobbying arm, the Drug Reform Coordination Network, which also pays the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Donald Trump has nominated a harsh drug warrior to head the Justice Department, Montanans will see a slew of bills aiming at making their medical marijuana system more workable (and at least one that wants to kill it), the Global Commission on Drugs called for drug decriminalization, and more.

Trump's Pick of Jeff Sessions as AG Raises Fears in Marijuana Industry. President-elect Donald Trump (R) has nominated anti-marijuana Alabama Republican Sen. Jeff Sessions to head the Justice Department, setting off alarms in the marijuana industry. As attorney general, Sessions would oversee federal prosecutors and the DEA and could move to undo the Obama administration's policy of largely allowing the states to set their own course on pot policy.

Colorado Bureaucrats Nix On-Site Pot Consumption for Bars. Just a week after voters in Denver approved a social use initiative allowing restaurants and bars to seek permits to allow on-site consumption of marijuana, the Department of Public Health and Environment has announced that it will not allow liquor license-holders to obtain such permits. The department said using alcohol and marijuana together increases impairment. But proponents of the measure said alcohol establishments already rely on the judgment of servers and that the move would allow consumers to use marijuana products without having to go outside or hide behind closed doors.

Medical Marijuana

Arizona Dispensary Operator Eyes 2018 Expansion Initiative. The owners of the Wellness Center, an Apache Junction dispensary, are moving toward an initiative to expand the state's medical marijuana program. The move comes a week after a legalization initiative was narrowly defeated. The initiative would expand the list of qualifying conditions for marijuana and it would allow people who live more than a mile from a dispensary to grow their own. The current law bars people who live within 25 miles of a dispensary from growing their own.

After Initiative Victory, Medical Marijuana Bills Pile Up in Montana. Montanans voted last week to restore their state's medical marijuana system, which had been gutted by the Republican legislature in 2011, and now the legislature faces at least 10 bills designed either to make the system more workable or to try to thwart the will of the voters once again. It's going to be a busy session in Helena.

New Report Calls on UK to Legalize Marijuana. A new report from the Adam Smith Institute says that Great Britain's drug strategy "has failed in its core aims to prevent people from using drugs, manufacturing drugs, and to put a stop to the crime, corruption and death that is taking place on an industrial scale around the world," and calls on the government to legalize marijuana. The report is winning support from a cross-party parliamentary group that includes former deputy prime minister Nick Clegg.

Global Commission on Drugs Calls for Global Drug Decriminalization. In its annual report, the Global Commission on Drugs has called for an end to criminal and civil penalties for drug possession and more research into alternative regulatory models. The report comes months after the commission sharply criticized the United Nations' refusal to embrace more radical drug reforms at its UNGASS on Drugs last spring. Commission member Richard Branson called the UN's status quo approach "fatally flawed" at the time.

Pain is a drag. And chronic pain is a never-ending drag. Unfortunately, as we grow older, we can expect to increasingly suffer its torments. Half of older adults who live on their own report suffering from chronic pain. For people in elderly care facilities, that figure jumps to somewhere around 80%.

Older patients reported relief and good quality of life with marijuana. (Darren Harris Frisby/DPA)

An aging population with its associated aches and pains is one reason opioid pain prescriptions have increased so dramatically this century. Opiates are a very popular pain management technique, despite the well-known problems with them, primarily addiction and lethality. They can ease your pain, but they can also kill you or get you strung out. And opiate users report other problems less severe, but still affecting quality of life, such as constipation and foggy-headedness.

In recent years, we have seen increasing evidence that one substance can reduce both pain and the reliance on opioids to treat it, and that its use can have a positive impact on fatal opioid overdoses. That substance is marijuana.

As the Johns Hopkins Bloomberg School of Public Health reported in 2014, "In states where it is legal to use medical marijuana to manage chronic pain and other conditions, the annual number of deaths from prescription drug overdose is 25% lower than in states where medical marijuana remains illegal."

Now, new research findings from Care By Design, one of California's leading medical marijuana producers, add more evidence of the positive role marijuana can play in treating chronic pain and reducing dependence on opioid pain medications. The study surveyed 800 patients, mostly between 50 and 70, more than 80% of whom reported suffering from chronic pain, half of whom reported suffering from acute pain, and more than 40% of whom reported suffering from both.

These patients were in a world of hurt and had tried a number of pain management tools—opiates, medical marijuana, anti-inflammatory agents (NSAIDS), nerve blockers, exercise/physical therapy, and surgery—with respondents reporting trying an average of four of them. A quarter of patients reported having tried all six.

The patients reported that marijuana was very effective for pain, with few negative side effects. That was in striking distinction to opiates, which patients also said were effective for pain, but had a significant negative impact on quality of life for a significant number of them. In fact, the differences between the two substances in terms of quality of life were so dramatic they led to dramatic changes in patient behavior.

Medical marijuana (Creative Commons/Wikimedia)

"This survey brings some very important information to light," said Care By Design spokesman Nick Caston. "We see here in our patient data that cannabis is improving the quality of life of our patients—particularly elderly patients suffering from age-related pain—and that it does so without the dangerous side effects of other pain management modalities.

"The study’s most striking finding was cannabis’ apparent impact on opiate reliance: Ninety-one percent of survey respondents reported that they decreased the amount of opiates they were taking or eliminated them altogether," Caston continued.

The study also found while marijuana, opiates, exercise/physical therapy, and NSAIDS all provided noticeable pain relief in more than half the patients, marijuana was the only pain management tool where there were no reports of worsening pain. And half of the patients using opiates reported that they had a negative impact on overall well-being, interfering with mood, energy, sleep, and functional abilities.

More than half of the patients reported using both marijuana and opiates to manage pain. But as noted above, nine out of 10 reduced or eliminated their opiate consumption after beginning to use marijuana. And nearly two-thirds (63%) said they were now off opiates altogether.

Over half of respondents reported that they had used both cannabis and opiates for pain management. Of great interest was the impact of cannabis therapy on opiate usage: Ninety-one percent of this subgroup reported that they used fewer or no opiates after beginning cannabis therapy. Sixty-three percent said that they went off opiates altogether.

"A tenet of healthcare in the United States is 'First, do no harm,'" the study concluded. "Patient reports of cannabis’ efficacy together with its low side effect profile suggest that it should be considered as a first-line treatment for pain and/or as an adjunct treatment to opiates rather than as a medication of last resort."

In other words, if we want to reduce the reliance on opioids, with all their negatives, for the management of pain in an aging population, we should be easing access to medical marijuana. With medical marijuana legal in 25 states, we're halfway there.